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Higher Liability Premiums Tied to Rising Caesarean Rates

Medical-legal climate may be contributing to an increased rate of Caesarean deliveries in Illinois

WEDNESDAY, Dec. 5 (HealthDay News) -- Rising medical professional liability premiums for obstetrician-gynecologists in Illinois may be partly to blame for increased rates of Caesarean deliveries in that state, reports a study published in the December issue of Obstetrics & Gynecology.

Karna Murthy, M.D., of Northwestern University in Chicago, and colleagues analyzed data from the National Center for Health Statistics including 817,521 singleton births occurring in Illinois between 1998 and 2003, to investigate the association between physician professional liability premiums and rates of primary Caesarean delivery.

During the study period, the mean primary Caesarean delivery rate increased from 126 to 163 per 1,000 eligible women. Mean annual medical professional liability insurance premiums also rose from $60,766 to $83,167 during the same time period. Multivariable analyses showed that an annual increase of $10,000 in insurance premiums was associated with an increase of Caesarean delivery rate by 15.7 per 1,000 women for nulliparous women and by 4.7 per 1,000 for multiparous women.

The authors comment that "an increase in Caesarean deliveries in response to external pressures, and not patient factors, could result in greater maternal and neonatal morbidity, not just in the present pregnancy but in future pregnancies as well. Further research should elucidate the relationship between malpractice pressures and these short-term and long-term perinatal outcomes."

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